Efficacy of Therapeutic Exercise on Activities of Daily Living and Cognitive Function Among Older Residents in Long-term Care Facilities: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Akio Okamae; Tatsuya Ogawa; Hyuma Makizako; Daisuke Matsumoto; Tomoya Ishigaki; Midori Kamiya; Toshinori Miyashita; Hikaru Ihira; Yoshiaki Taniguchi; Shogo Misu; Takeshi Ohnuma; Tomohisa Chibana; Natsu Morikawa; Tome Ikezoe

doi:10.1016/j.apmr.2022.11.002

Efficacy of Therapeutic Exercise on Activities of Daily Living and Cognitive Function Among Older Residents in Long-term Care Facilities: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Arch Phys Med Rehabil. 2023 May;104(5):812-823. doi: 10.1016/j.apmr.2022.11.002. Epub 2022 Nov 28.

Authors

Affiliations

¹ Department of Rehabilitation, Hyogo College of Medicine Sasayama Medical Center, Kurooka, Tambasasayama, Japan. Electronic address: okamae@hyo-med.ac.jp.
² Department of Rehabilitation, Nishiyamato Rehabilitation Hospital, 3-2-2 Sasayuridai, Kanmaki, Japan.
³ Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan.
⁴ Department of Physical Therapy, Faculty of Health Sciences, Kio University, Koryo, Japan.
⁵ Department of Physical Therapy, Faculty of Rehabilitation Sciences, Nagoya Gakuin University, Nagoya, Japan.
⁶ The First Nursing Course, Aichi Prefectural School of General Nursing, Nagoya, Japan.
⁷ Inclusive Medical Science Research Institute, Morinomiya University of Medical Sciences, Osaka, Japan.
⁸ Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan.
⁹ Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan; Department of Physical Therapy, Kagoshima Medical Professional College, Kagoshima, Japan.
¹⁰ Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, Kobe, Japan.
¹¹ Rehabilitation Progress Center Incorporated, Itabashi rehabili home-visit nursing station, Tokyo, Japan.
¹² Kawaguchi Neurosurgery Rehabilitation Clinic, Hirakata, Japan.
¹³ Boys & Girls, Daycare facilities for persons with severe motor and intellectual disabilities, Toyonaka, Japan.
¹⁴ Faculty of Rehabilitation, Kansai Medical University, Hirakata, Japan.

PMID: 36574530
DOI: 10.1016/j.apmr.2022.11.002

Abstract

Objectives: This study aimed to systematically analyze the efficacy of therapeutic exercise on activities of daily living (ADL) and cognitive function among older residents in long-term care facilities.

Data sources: PubMed, Cochrane Central of Register Trials, Physiotherapy Evidence Database, OTseeker, and Ichushi-Web were searched from inception until December 2018.

Study selection: Databases were searched to identify randomized controlled trials (RCTs) of therapeutic exercise for long-term care facility residents aged 60 years and older, focusing on ADL and cognitive function as outcomes.

Data extraction: Two independent reviewers extracted the key information from each eligible study. Two reviewers independently screened and assessed all studies for eligibility, extracting information on study participants, details of interventions, outcome characteristics, and significant outcomes. Any discrepancies were resolved by a third reviewer.

Data synthesis: A total of 11 RCTs with 1280 participants were eligible for analyses. Therapeutic exercise had a significant benefit on ADL (standard mean difference [SMD]=0. 22, 95% confidence interval [CI]: 0.02, 0.42, P=.03). Subgroup analyses indicated that interventions conducted ≥3 days per week [SMD=0.42, 95% CI 0.02, 0.82, P=.04] had a significant benefit on ADL. For cognitive function, group exercise and ≥3 days/week of intervention had a significant benefit (group exercise: mean difference [MD]=3.36, 95% CI 0.91, 5.80, P=.007; ≥3 days/week of intervention: MD=2.28, 95% CI 0.07, 4.49, P=.04).

Conclusions: Therapeutic exercise conducted 3 or more days per week may be effective for improving ADL and cognitive function among older residents in long-term care facilities. This meta-analysis suggested that group exercise for cognitive functions was effective. However, the effective method of intervention delivery for ADL was unclear.

Keywords: Activities of daily living; Cognition; Exercise therapy; Long-term care; Rehabilitation.

Publication types

Meta-Analysis
Systematic Review
Review

MeSH terms

Activities of Daily Living*
Aged
Cognition
Exercise Therapy
Humans
Long-Term Care*
Middle Aged
Randomized Controlled Trials as Topic